Wherever else you think you're going,Stop for a moment and look where you are:You Have Arrived!

I believe in you.You deserve to be healthy. You deserve to be kind to yourself.You deserve to achieve your greatest level of success with weight loss surgery when you harness your inner resources.--Kaye Bailey5 Day Pouch Test Owner's Manual

The Nurse Warned Me,But I Gained Weight Back Anyway

"Dear Kaye,Thank you for the Day 6 book. I guess I am one of "those people" - had the surgery and lost and then it came back, the weight. My WLS nurse warned me I could regain the weight and I didn't take her serious or maybe I thought I was more determined than everybody else or smarter or something. I wish I had asked her what would cause me to gain the weight back. I'm not sure that back in 2007 I ever heard of slider foods or liquid rules or anything like that. I just knew WLS was the answer for me. So now I'm up 48 pounds and want to stop it before it gets to 50 pounds and all of the sudden another 50 and I'll be back where I started. Thanks for explaining so many things in the Day 6 book. I wish I read this book before I even had the surgery, maybe I wouldn't be one of "those people" or at least not a 48-pound-regain one of those people.

This is the first time I have hope since the re-gain started.

Kelly MarcaNorthern Ohio"

Printed with Permission.

Because we are all "One of those people" who have or could regain our weight.

By Kaye Bailey I was born with the disease obesity and by the time I was out of college it had advanced to morbid obesity. At age 33 my disease was treated with gastric bypass surgery which affected a loss of weight that put my disease, morbid obesity, in remission. Three years later I suffered a relapse of my disease with a weight gain of 20 pounds. Through dietary and lifestyle compliance, much like a person with heart disease who suffers a relapse, I was able to put my disease, obesity, back in remission. I will always have the disease of morbid obesity and am fortunate that I was able, at a young age, to be treated with the best medically available option.

The Facts:Obesity is a disease.

Weight loss puts the disease in remission.

Weight gain puts the disease in relapse.

Like most diseases, victims of obesity are responsible to make dietary and lifestyle changes that work with medical treatment to keep our disease in remission.

My Four Truths:Regain Is Likely: It is generally believed that 80% of people who undergo weight loss surgery (WLS) will experience weight gain (relapse) of 10-30 pounds depending upon initial weight loss. It is further believed that 20% of those will relapse to their former weight and possibly gain more as the disease of morbid obesity advances. This relapse can be the result of failed gastric surgery (the surgery was improperly performed or medical device failure); a non-compliant patient who does not evolve their eating and exercise habits; the active intestine becoming more efficient at absorbing calories; and potential stomach pouch stretch. Dr. Anita Courcoulas, chief of minimally invasive bariatric and general surgery at the University of Pittsburgh Medical Center said, "Regaining weight down the road is a common phenomenon for weight loss patients. These patients need to be educated and prepared for it if it happens."

100% Conviction: It is my experience that 100% of patients who take to the operating table for the treatment of their disease say, "I'm not going to be one of those people who gain weight after surgery." You can bet the farm I said that - and imagine my embarrassment and shame when I did in fact become one of those people. At the time I didn't understand my disease had relapsed, in part because I had relaxed my newly evolved eating and exercise habits, but also because my body has a disease that wants to store excess fat. I thought I gained weight because I was a failure at surgery.

I failed AGAIN! I am not alone in my feelings of failure over weight regain. Dr. Courcoulas said, "These are people who feel that they have failed at everything they tried in their lives. If they feel that they are failing surgery, they're embarrassed and they don't want to come back for help." How sad for us. When a cancer patient suffers a relapse do they take it as a personal failure? I sure hope not. Popular media perpetuates the belief that weight gain equals failure. WLS celebrities are splashed across mainstream media and tabloids alike for weight regain. But the celebrity with cancer who suffers relapse? Charity benefits are hosted bearing their name and their bravery is lauded. With a relapse in obesity the celebrity becomes the brunt of jokes for late night comedians. No wonder we don't want to become one of those people but statistics are not on our side

I Am Not Obese. Since kindergarten the word "fat" defined me and I actually thought that was who I was because "You are fat" and "I am fat" were constant phrases in my world. By about age 40 I finally figured out that I am not fat. I have obesity, a disease. Have you heard a heart attack patient say, "I am heart disease" or a leukemia patient say, "I am cancer"? We are not the disease! We have a disease that is part of the whole person that makes us the wonderfully unique and powerful person we are.

Relapse to Remission:Just like other diseases, obesity relapse can be put into remission. There is hope! As noted above there are (at least) four reasons for relapse including: failed gastric surgery; a non-compliant patient who does not evolve their eating and exercise habits; the active intestine becoming more efficient at absorbing calories; and potential stomach pouch stretch. Keeping in mind that statistically weight regain is likely, that you are not a failure, and that you are not the disease, you can pragmatically go about mapping a plan to fight your relapse.

Seek medical help and treatment: you are fighting a killer disease

Assess your eating and exercise evolution and return to the lifestyle prescribed at the time of surgery

Educate yourself on nutrition, physical and spiritual health so they may work in harmony to heal your body

Educate others to stop the ignorance and blame and promote the understanding of this illness we are fighting.

Kaye Bailey 2010-2011 - All Rights Reserved.

LivingAfterWLS Empowerment

LivingAfterWLS believes that success with weight loss surgery, and in life, can be found when we focus on inner strength rather than inner weakness.The first step to personal empowerment is personal responsibility. LivingAfterWLS holds individuals accountable for making their weight loss surgery successful. When individuals take responsibility they feel liberated and motivated to invest personal equity in their success. Become Empowered to invest in your personal weight loss surgery success!Read the LivingAfterWLS Empowerment Philosophy

I hope this letter finds you healthy and well and excited to begin a New Year and New Decade at that!

At the risk of raining on the New Year's Parade I am starting the year off on a very somber note. In fact, I have been in disagreement with my editorial coaches for several weeks over writing about this topic for you. But in my heart-of-hearts I believe this is the most important message I can share with you right now and one that will make a difference in how you feel about yourself and your health and your weight loss surgery. There is a very good risk that some will become angry or indignant with me, my words, and this message. I understand and do not mean to cause hurt. But I speak from the heart without judgment or malice because this is my experience and my truth just like it is the truth and experience for many of you. So please, accept with an open heart my conversation on the WLS-Split Personality Syndrome*. Let me know if it hits the mark for you. Because once we see it and know it is exists, understanding begins and so does the healing. We did not choose the medical condition of morbid obesity for ourselves; but we most certainly can choose the path of healing and longevity for ourselves. Weight loss surgery was a courageous choice not wrought on a whim. And that is why I put down my cheerleading pom-poms today to share with you this somber and hopefully powerful and empowering message.

Happy 2011 - We are all in this together!

KayeKayeBailey@LivingAfterWLS.com

*WLS-Split Personality Syndrome is a term I coined although I am not in the business of coining such terms. It fundamentally describes a typical behavioral pattern I see in myself and many other weight loss surgery patients.

WLS-Split Personality Syndrome

by Kaye Bailey

If you have undergone a bariatric surgical procedure to control the metabolic disorder causing you to suffer from morbid obesity then you understand what it means to jump through hoops. Unlike any other life threatening illness people suffering from morbid obesity have to prove they are sick enough to undergo surgical intervention and mentally healthy enough to adapt to that treatment and its consequences.

I jumped through the hoops to get treatment with hell-bent determination that if I could just get this one break, some help from the good doctor, I would follow the rules and comply with every request. I would never be "one of those people" who get the surgery only to briefly lose weight and gain it all back. I did everything in my power to convince myself, my doctors, my insurance company, and even my Lord that I would die a miserable sickly death of co-morbidities if I did not have surgery to lose weight and save my life.

And that hell-bent determination carried me well, for a time. I did lose weight and I did comply with the rules and restrictions of surgery. And I did praise my surgeon, and my insurance company, and my Lord that my life was spared and I was healthy, alive, and living. I suppose with all that praising going on I kind of lost sight of the path, left the course really, all in the name of living. Pretty soon I wasn't eating protein first or drinking lots of water. My daily exercise was hit-and-miss and a little snacking never hurt anyone, right? Somewhere the fighting survivor personality gave way to a what-me-worry wanderlust personality that didn't bother to look at the map.

We cannot successfully manage our health with this surgery if we enable split-personality behavior.

The minute we give up the hell-bent fighter and survivor personality in exchange for the happen-chance dieter of lost-pounds-past we are at risk of gaining weight, of feelings of failure, and worst of all: we are at risk of succumbing to the metabolic disorder we fought so damn hard to have treated with bariatric surgery. We cannot have it both ways. If we truly believe our obesity is a medical condition -and by medical definition it is- then we must yesterday, today, and always consider it a medical condition. We cannot be gut-whacked one day for the sake of saving our life and the next day abandon the dietary rules like we could a few weight loss programs back when on a whim we joined a strip mall diet program advertising "Join Now! Walk-ins Welcome."

You see, this bariatric surgery, it is serious business. There is no whimsy in the decision to get gut-whacked, no neon sign blinking "Walk-ins Welcome." No lose 10 pounds or get your money back promotion.

Think back to the days and weeks prior to your surgery. Like me, you talked the subject to wearisome repetition with your closest confidant. You put your personal and financial affairs in order. You signed a liability release praying not to be the rare death-on-the-table, a risk to one out of a hundred of us. You set goals. You made your expectations known: what you expected of yourself and what you expected from others as you beseeched their support in this - your last hope at saving your life from a slow painful death from the complications of morbid obesity. Your claims were heartfelt and emphatic: You wanted to be there to see your children grown and maybe grandchildren too. You wanted to live.

This bariatric surgery is serious business.

It is a funny thing, the way the mind works. The healthier we become the less we remember how truly sick we were before surgery and before weight loss. Similar to the memory of pain reported following childbirth, findings indicate that the more positive our experience is with weight loss, the less vividly we recall the pain (physical and emotional) of obesity prior to weight loss. This suggests when we fall off the wagon of dietary compliance it is not so much about a moral breakdown or environmental pressure (think food pushers) but perhaps we just don't remember how bad obesity felt. The same is likely true for a recovering addict who returns to the drug of choice: they simply do not recall the agony of the addiction. This could explain why highly intelligent people often repeat the cycle of recovery and relapse befuddling those around them.

Toddlers are taught very quickly not to touch a hot stove. It only takes three little sharply spoken words, "Hot! Don't touch!" and one breach of the command and even the dimmest child learns not to touch the hot stove because doing so causes immediate pain. Behavior modification therapy works in a similar manner for adults. Some are taught to wear a rubber band on the wrist and when temptation for relapse occurs the band is snapped in a "Hot! Don't touch!" alert that danger looms.

The problem we encounter in the recovery from morbid obesity is that the environmental factors that feed our metabolic disorder don't burn when we touch them. Chocolate cake tastes good and macaroni and cheese feels comforting when we eat it. There is no sting from the snap of a rubber band, no burn from the heat of the stove. A 1972 love anthem recorded by Luther Ingram gave us those memorable cheating words, "If loving you is wrong, then I don't want to be right." Remember that classic? How easily it could be the theme song in our forever battle of the bulge.

I dare say the best "Hot! Don't touch!" snap for us comes when we understand the risk for split personality behavior following a bariatric surgery for weight loss. While it doesn't seem desirable to dwell upon the pain we suffered from our obesity it would serve us well to not forget it. Photos are a good reminder. I suggest not just the usual "before" picture, but how about a photo of your prescription medications or the CPAP breathing machine you had to wear at night, or the cane or walker you needed because your mobility was impaired? Those photo reminders will feel very much like a snap on the wrist and catapult your personality to being hell-bent on sustained recovery.

At LivingAfterWLS we use the Quarterly Self-Assessment 2-page worksheet (download here for free) to take inventory of where we are and where we want to go. The second assessment question is "What was my original goal when I had WLS?" This personal contract is an accountability tool to help us keep our morbid obesity in remission. And I'm pretty sure that for most us keeping morbid obesity in remission was the original goal.

Peer support also effectively nurtures our hell-bent personality in recovery. We can learn from those who are further down the road from us and we can tap into the enthusiasm of those new to recovery to boost our resolve when things feel redundant and routine. And who doesn't like having a cheering section when those baby steps become big accomplishments? Join our online safe haven circle of friends - the LivingAfterWLS Neighborhood - to learn what I'm talking about.

Keep learning. Continued education works to keep us informed, trying new things and having new hope that a remission from our medical disorder is achievable. And reaching out to support others becomes a self-fulfilling prophecy as we benefit from the give and take of a generous spirit. Learn, teach, share. We are in this together.

Now that I have laid this out for you I want to bring back the pom-poms and the cheerful optimism. The surgical tool gives us something no strip-mall "Walk-ins Welcome" weight loss program ever will: the ability to bounce back time and time again. We can get back on track and we can work our stomach pouch to manage our metabolic disorder. We have learned how good it can feel to manage our weight and we can do it again. So harness that hell-bent personality. Grab your original goal by the love handles and take charge of your destiny. I am here for you and we are in this together. Not for just a few pounds; not just to goal weight. We are in this together for the purpose of living. You can do this!

The LivingAfterWLS Neighborhood: an online compassion driven social space evoking feelings of comfort, understanding, knowledge, warmth, acceptance, trust and happiness for those who have undergone gastric bypass, lap-band or any type of weight loss surgery or those struggling with weight control.

5 Day Pouch Test ForumAlways a popular destination the 5 Day Pouch Test Forum is your place to connect with others who are using this popular plan to get back on track with their weight loss surgery tool.

Day 6: Beyond the 5 Day Pouch TestHarness the momentum of your 5 Day Pouch Test and continue forward with a positive effort at Day 6 Living. Great support from others, like you, who are trying their best to live healthy happy lives with weight loss surgery.

The You Have Arrived Alumni ClubConnect with others who had weight loss surgery the same year you did and share the journey! From the Pioneers of the 1980s to our newbies of 2010, everyone has a place in the Alumni Club to call home.

The Picket FenceA place to stop and share the things in our daily lives beyond weight loss surgery. A neighborly place of support and friendship.

In Kaye's usual comforting style she shares three red flag warnings that may signal weight gain after weight loss surgery. Avoid weight gain by being aware of the warnings and how to change direction. Empowering your weight loss surgery success!